Genetic underpinnings of callous-unemotional traits and emotion recognition in children, adolescents, and emerging adults

Meanness and deficits in facial affect processing: Evidence from the N170

The triarchic construct of meanness, characterized by traits such as low empathy and lack of remorse, appears to be associated with deficits in affective processing. Specifically, meanness-related traits have been linked to deficits in brain reactivity and recognition of facial emotion. Recent meta-analytic work has provided preliminary evidence suggesting that N170 ERP amplitude reductions to fear faces might serve as a neurophysiological marker for meanness traits. However, most of these studies do not examine emotions other than fear, leaving open the question of whether meanness-related alterations in fear face processing might generalize to other facial expressions, nor the role of the other constructs of the triarchic model of psychopathy (i.e., boldness and disinhibition). The current study aimed to address these issues by measuring N170 amplitudes in a mixed-gender sample of 119 undergraduates while they passively viewed a broader range of emotional facial expressions (Anger, Fear, Happiness, and Neutral) alongside control (Scrambled) pictures. The specificity of this association to trait meanness compared to the other triarchic constructs was also assessed. Our results demonstrated meanness-related reductions in N170 amplitudes across all types of facial expressions, not just to fearful faces, even after controlling for the overlap with the other triarchic constructs. These findings highlight a general deficit in the structural encoding of facial features in high mean individuals, emphasizing the potential role of the N170 as a physiological tool for advancing our understanding of the mechanisms contributing to the aggressive, callous, and low-empathic characteristics of psychopathy.

Callous-unemotional Traits and Emotion Recognition Difficulties: Do Stimulus Characteristics Play a role?

Emotion recognition difficulties are linked to callous-unemotional (CU) traits, which predict risk for severe antisocial behavior. However, few studies have investigated how stimulus characteristics influence emotion recognition performance, which could give insight into the mechanisms underpinning CU traits. To address this knowledge gap, children aged 7-10 years old (N = 45; 53% female, 47% male; 46.3% Black/African-American, 25.9% White, 16.7% Mixed race or Other, 9.3% Asian) completed an emotion recognition task featuring static facial stimuli from child and adult models and facial and full-body dynamic stimuli from adult models. Parents reported on CU traits of children in the sample. Children showed better emotion recognition for dynamic than static faces. Higher CU traits were associated with worse emotion recognition, particularly for sad and neutral expressions. Stimulus characteristics did not impact associations between CU traits and emotion recognition.

Deficits in emotion recognition and processing in children with high callous-unemotional traits: the role of the MAOA gene

Children with high Callous-Unemotional (CU) traits show deficits in recognizing and processing facial expressions. Alterations in emotion recognition have been linked to a higher synaptic concentration of monoaminergic neurotransmitters. The current study investigated the relationship between the MAOA-Low-activity alleles and the ability to recognize and process facial expressions in 97 male children (8-12 years old) diagnosed with disruptive behavior disorder. Participants completed a computerized emotion-recognition task while an eye-tracking system recorded the number (Fixation Count, FC) and length (Fixation Duration, FD) of fixations to the eye region of the emotional stimuli. Children with high CU traits exhibited lower scores in recognition of sadness and anger, and lower FC and FD for sadness and fear than children with low CU traits. Children carrying the MAOA-Low-activity alleles displayed lower FD for sadness, and FD and FC for fear than those carrying the MAOA-High-activity alleles. These genetic effects appeared even stronger in children with CU traits. Moderation analysis revealed that CU traits were associated with lower FC and FD for fear, and lower FD for sadness, probably due to the MAOA-Low-activity alleles. Our findings, although to be replicated, suggest MAOA-Low-activity alleles as potential genetic biomarkers to identify CU children in need of training focused on emotion processing.

Emotion Identification for Self and Other Associated with Callous-Unemotional Traits and Sex Differences in Early Adolescents

Callous-unemotional traits (CU) associates with impairments in emotional responsivity. However, there is less evidence on associations with specific emotions and sex differences utilizing both self and other oriented emotional stimuli. Given that the nuance of associations with specific emotions (including sex effects) is critical for understanding core impairments of this antisocial phenotype, the current study employed a behavioral paradigm with both self and other emotional stimuli for specific emotions (happy, sad, anger, fear, neutral) with a sample of male and female early adolescents (females = 51%, age = 12.86 ± 0.75). We examined accuracy and reaction times on this task, along with moderating effects of sex, in relation to CU traits. Results indicate CU traits associated with overall self-emotions negatively and sex moderated CU traits negative association with recognizing others overall emotions. CU traits negatively associated with accurate identification of both self and other emotions (happy, sad, and fear). Sex moderated all other emotion identification but only sad emotions for self. No reaction time differences were found. These findings evidence important nuance in CU traits and sex effects with identifying self and other emotions. Results have important implications for clinical understanding of sex differences in CU traits that require further consideration.

Emotion Recognition Deficits in Children and Adolescents with Psychopathic Traits: A Systematic Review

Children and adolescents with psychopathic traits show deficits in emotion recognition, but there is no consensus as to the extent of their generalizability or about the variables that may be moderating the process. The present Systematic Review brings together the existing scientific corpus on the subject and attempts to answer these questions through an exhaustive review of the existing literature according to PRISMA 2020 statement. Results confirmed the existence of pervasive deficits in emotion recognition and, more specifically, on distress emotions (e.g., fear), a deficit that transcends all modalities of emotion presentation and all emotional stimuli used. Moreover, they supported the key role of attention to relevant areas that provide emotional cues (e.g., eye-region) and point out differences according to the presence of disruptive behavior and based on the psychopathy dimension examined. This evidence could advance the current knowledge on developmental models of psychopathic traits. Yet, homogenization of the conditions of research in this area should be prioritized to be able to draw more robust and generalizable conclusions.

Is the distinction between tonic and phasic irritability meaningful in 3-year-old children?

Irritability encompasses both normative misbehavior in early childhood and clinically significant problems across development. Recent studies have distinguished between tonic (i.e., persistently angry or grumpy mood) and phasic (i.e., temper tantrums or outbursts) forms of irritability and shown that they have different implications for psychopathology and functioning. However, data on this distinction in young (i.e., preschool aged) children are nonexistent. We utilized data from a longitudinal study of a community sample of 462 3-year-olds followed to age 15. We conducted confirmatory factor analysis (CFA) using items from a diagnostic interview and several parent-report inventories and examined concurrent and prospective associations with clinically relevant variables. The CFA identified dimensions consistent with tonic and phasic irritability. Tonic irritability was independently associated with concurrent parent-reported temperamental negative affectivity and surgency, and depressive and oppositional defiant (ODD) disorders, and predicted higher rates of disruptive behavior disorders (DBD) and suicidal behavior in later childhood and adolescence. Phasic irritability was independently associated with concurrent laboratory observations of child impulsivity, parent-reported temperamental negative affectivity, surgency, and low effortful control, maladaptive parenting, and generalized anxiety disorder (GAD), attention-deficit hyperactivity disorder (ADHD), and ODD, but it did not predict later psychopathology. Tonic and phasic irritability are separable in 3-year-old children, but their correlates and outcomes are not as distinct as in older youth. This may reflect the greater difficulty characterizing normative and pathological irritability in the preschool period.

Moral reasoning, emotion understanding, and callous-unemotional traits in early-to-middle childhood

Relatively little is known about features of moral reasoning among young children with callous-unemotional (CU) traits (e.g., lack of guilt and empathy). This study tested associations between CU traits and emotion attributions (i.e., identification of others' emotional states) and justifications (i.e., explanations for those emotional states), across social scenarios involving discreet versus salient distress cues. The participants were boys aged 6-to-10 years (N = 50; Mage  = 7 years 7 months), who were interviewed about 12 hypothetical scenarios (eight with discreet and four with salient distress cues). Regression models indicated that CU traits, in interaction with high levels of antisocial behaviour, were associated with reduced emotion attributions of fear in discreet but not salient immoral scenarios. Higher CU traits were also associated with reduced justifications referencing others' welfare in discreet scenarios, and increased references to action-orientated justifications in salient scenarios. These findings suggest that CU traits are associated with early moral reasoning impairments and that salience of distress may be important to these processes.

Psychopathy in women: insights from neuroscience and ways forward for research

Psychopathy is a severe form of personality disturbance, resulting in a detrimental impact on individuals, healthcare systems, and society as a whole. Until relatively recently, most research in psychopathy has focused on male samples, not least because of its link with criminal behavior and the large proportion of violent crime committed by men. However, psychopathy in women also leads to considerable problems at an individual and societal level, including substance misuse, poor treatment outcomes, and contribution to ever-increasing numbers of female prisoners. Despite this, due to relative neglect, most research into adult female psychopathy is underpowered and outdated. We argue that the field needs revitalizing, with a focus on the developmental nature of the condition and neurocognitive research. Recent work international consortia into conduct disorder in female youth-a precursor of psychopathy in female adults-gives cause for optimism. Here, we outline key strategies for enriching research in this important field with contemporary approaches to other psychiatric conditions.

Pediatric anxiety associated with altered facial emotion recognition

Multiple psychiatric disorders are associated with difficulties in facial emotion recognition. However, generalized anxiety disorder may be associated with more accurate recognition of others' emotional expressions, particularly expressions of happiness and fear, which index safety and threat. Children aged 9-14 from a community sample (N = 601) completed a facial emotion labeling task. Children's symptoms of depressive and anxiety syndromes were assessed by self- and parent-report. Elevated symptoms of generalized anxiety disorder were associated with more accurate facial emotion recognition (β = 0.16, p = 0.007), specifically recognition of happiness (β = 0.17, p = 0.002) and fear (β = 0.15, p = 0.006). Elevated depressive symptoms were associated with less accurate facial emotion recognition (β = -0.12, p = 0.018), specifically happiness (β = -0.15, p = 0.002). Elevated symptoms of separation anxiety disorder were also associated with less accurate facial emotion recognition (β = -0.16, p = 0.003), specifically happiness (β = -0.15, p = 0.006) and fear (β = -0.15, p = 0.005), which highlights the importance of distinguishing between anxiety syndromes. Results held when adjusting for child age and sex. Evidence that symptoms of generalized anxiety disorder are associated with more accurate recognition of happiness and fear is consistent with theories of heightened social vigilance and support a transdiagnostic role of facial emotion recognition that may inform the psychosocial development of youth with anxiety and depressive symptoms.

Autonomic Nervous System Inflexibility During Parent-child Interactions is Related to Callous-unemotional Traits in Youth Aged 10-14 Years Old

Youth with callous-unemotional (CU) traits are at high risk for aggression and antisocial behavior. Extant literature suggests that CU traits are related to abnormal autonomic responses to negatively-valenced emotional stimuli, although few studies have tested autonomic responding specifically during social interactions. To address this knowledge gap, the current study tested whether CU traits were related to autonomic activity, assessed via respiratory sinus arrhythmia (RSA), during several parent-child interaction tasks designed to provoke negative emotion. The sample was 162 clinically referred youth (M age = 12.03, SD = .92; 47% female). Using piecewise latent growth models, we estimated individual differences in RSA during three semi-structured social interaction tasks (reading aloud to a parent and research assistant; a recovery period from the reading task; and a parent-child conflict discussion) and tested whether CU traits were related to patterns of RSA responding across tasks. Overall, youth showed expected RSA decreases during the reading period, increases in RSA during recovery, and further decreases during the conflict discussion. However, youth with clinically-elevated CU traits had a different pattern of RSA change across tasks, such that CU traits were related to significantly less RSA change during reading and recovery. Findings suggest that less RSA engagement during social interactions and less RSA recovery may be a biomarker of CU traits. Future research is needed to examine whether this inflexibility contributes to the development of CU traits beginning early in childhood.

In the eyes of the beholder: investigating the effect of visual probing on accuracy and gaze fixations when attending to facial expressions among primary and secondary callous-unemotional variants

Individuals with callous-unemotional (CU) traits show deficits in facial emotion recognition. According to preliminary research, this impairment may be due to attentional neglect to peoples' eyes when evaluating emotionally expressive faces. However, it is unknown whether this atypical processing pattern is unique to established variants of CU traits or modifiable with intervention. This study examined facial affect recognition and gaze patterns among individuals (N = 80; M age = 19.95, SD = 1.01 years; 50% female) with primary vs secondary CU variants. These groups were identified based on repeated measurements of conduct problems, CU traits, and anxiety assessed in adolescence and adulthood. Accuracy and number of fixations on areas of interest (forehead, eyes, and mouth) while viewing six dynamic emotions were assessed. A visual probe was used to direct attention to various parts of the face. Individuals with primary and secondary CU traits were less accurate than controls in recognizing facial expressions across all emotions. Those identified in the low-anxious primary-CU group showed reduced overall fixations to fearful and painful facial expressions compared to those in the high-anxious secondary-CU group. This difference was not specific to a region of the face (i.e. eyes or mouth). Findings point to the importance of investigating both accuracy and eye gaze fixations, since individuals in the primary and secondary groups were only differentiated in the way they attended to specific facial expression. These findings have implications for differentiated interventions focused on improving facial emotion recognition with regard to attending and correctly identifying emotions.

Child maltreatment risk mediates the association between maternal and child empathy

BACKGROUND

Empathy deficits are related to parental maltreatment, and early exposure to maltreatment is associated with later impairments in social and interpersonal skills, possibly as the result of specific deficits in cognitive and emotional empathy.

OBJECTIVE

To examine the association between maternal and child's emotional and cognitive empathy, and how this relationship is mediated by maltreatment risk.

PARTICIPANTS AND SETTING

462 mothers of 4-10 years olds (48 % girls; M = 6.51 ± 1.57) were recruited through an online platform (Prolific Inc.) during 2018.

METHODS

Mothers were asked to report on their own cognitive and emotional empathy, views related to abuse risk, and their child's cognitive and emotional empathy.

RESULTS

Findings show that maternal perspective taking (a measure of cognitive empathy), and maternal personal distress predict child's cognitive empathy through abuse risk (beta = -0.29, p value = 0.0002 and beta = 0.22, p value = 0.0001, respectively). Conversely, for child's emotional empathy there was no mediation through abuse risk, rather direct associations were observed for empathic concern (a measure of emotional empathy; beta = 0.36, p value = 0.0197), personal distress (beta = 0.23, p value = 0.0332), and the fantasy scale (another measure of cognitive empathy; beta = 0.36, p value = 0.0019).

CONCLUSIONS

These findings help clarify the complex links between maternal empathy, abuse risk, and child's empathy, showing that maternal views related to abuse are specifically predictive of child's cognitive but not emotional empathy. As such, these findings raise further questions regarding the mechanism by which maternal characteristics and behavior are associated with child's empathy.

The genetic and environmental origins of emotional and cognitive empathy: Review and meta-analyses of twin studies

Empathy is considered a cornerstone of human social experience, and as such has been widely investigated from psychological and neuroscientific approaches. To better understand the factors influencing individual differences in empathy, we reviewed and meta-analyzed the behavioral genetic literature of emotional empathy- sharing others' emotions (k=13), and cognitive empathy- understanding others' emotions (k = 15), as manifested in twin studies. Results showed that emotional empathy is more heritable, 48.3 % [41.3 %-50.6 %], than cognitive empathy, 26.9 % [18.1 %-35.8 %]. Moreover, cognitive empathy as examined by performance tests was affected by the environment shared by family members, 11.9 % [2.6 %-21.0 %], suggesting that emotional understanding is influenced, to some degree, by environmental factors that have similar effects on family members beyond their genetic relatedness. The effects of participants' age and the method used to asses empathy on the etiology of empathy were also examined. These findings have implications for understanding how individual differences in empathy are formed. After discussing these implications, we suggest theoretical and methodological future research directions that could potentially elucidate the relations between genes, brain, and empathy.

Editorial: Correlation and causation: to study causality in psychopathology

The desire to seek explanations and causal patterns is deeply embedded in human nature. This has long been acknowledged, and as early as 29 BC Virgil stated "Lucky is he who has been able to understand the causes of things" (Pearl & Mackenzie, 2018). Yet still, the science of causality is quite new, and has developed much more recently than for instance probability and significance testing (Pearl, 2018). However, during the last 10-15 years a new focus on causal inference has affected how scientists think in most empirical fields in a way that some even argue represents a causal revolution (Pearl, 2018). The increased understanding of the logic behind causal reasoning has also affected how we study psychopathological development. It is now well acknowledged that the complexity of development and developmental disorders means we require explanations on different levels, using different research designs. The articles in this issue illustrate this in various ways.